The headline number
In 2024–25, 28.7 per cent of Australian men aged 15–24 delayed or did not see a GP when they needed to. Among men aged 25–34, the figure was 22.9 per cent. Across the wider male population, more than one in five didn’t see a GP at all. The pattern is the same once you look at regular GP relationships rather than visits: the AIHW’s continuity-of-care work shows men, younger adults, and people in good apparent health consistently score lowest on continuity, regardless of how it’s measured.
Most of these people aren’t avoiding healthcare. They’re healthy. They’ve moved cities or states. They’re busy. They manage their own health. They’ve used telehealth a few times for a script and never needed more. The “ongoing relationship with a single GP” model fits some patients beautifully and these patients very poorly.
Working-age, often male, often without a chronic-condition diagnosis yet, and often presenting because weight is the first health issue they’ve sought structured help for. With no established GP relationship (or any particular desire for one), a telehealth avenue is a frictionless one. The system’s assumption, that the GP knows them, the GP will hold the long-term thread, the GP will catch what we miss, doesn’t hold here.
So what does good care look like when the assumption breaks?
The opportunity, not the gap
The instinct in primary care is to treat the absence of a regular GP as a problem. It is, in the system-design sense. But for the individual patient walking into a weight management consult, it’s also an opportunity: one most won’t have seen before.
Here is what the patient often hasn’t experienced: a structured clinical history-taking process they can complete at their own pace. A clinician who has actually read what they wrote before walking into the room. A consultation where the questions are specific, the probing is informed, and nothing is being squeezed into fifteen minutes between two other patients. A follow-up cadence that doesn’t require them to remember to book. A system that holds the longitudinal thread for them, because they haven’t held it themselves.
For a patient whose previous experience of healthcare is “telehealth GP, ten-minute call, repeat script, gone,” the structure of a specialist-governed program with proper intake and ongoing review is genuinely different. Not different in the sense of replacing a GP, which it can’t and shouldn’t try to do. Different in the sense of providing the continuity these patients have not previously had access to in any form.
That’s the frame worth holding. The patient who comes in without a regular GP is not someone we have to apologise to or compensate for. They’re someone the model can actually serve well, if it’s built for them.
The intake does the lifting
In low-continuity care, the intake is doing the work that a longstanding GP relationship would normally do. This sounds onerous. Designed well, it isn’t.
The online format helps. A patient sitting at home, on their own time, prompted thoughtfully, will surface more relevant history than the same patient in a 15-minute consult. They have time to remember. They can pause, check what medication they’re actually on, ask a partner about a family history detail. The structure of the prompts, what to think about, what matters, what the clinician will want to know, does work the patient has often never been asked to do before.
The areas where this matters most are predictable. Family history of cardiovascular disease, diabetes, and cancer. Previous attempts at weight management, including what worked and what didn’t. Mental health history, including periods where things were harder than they look on paper now. Current and past medications, including ones the patient might not consider relevant. Sleep patterns and any history of disordered eating. Cardiovascular risk markers if they’re known. The biopsychosocial picture that a long-term GP would already hold in their head.
The clinician then walks into the consultation already informed. The conversation isn’t gathering history; it’s checking, deepening, and validating it. That’s a different consultation, and a better one. The patient feels seen because the questions are specific. The clinician makes better decisions because the picture is more complete.
A patient with a regular GP can get this kind of intake too, of course. But for a patient without one, it’s often the first time they’ve experienced healthcare designed this way. That impression matters, because we want them to engage with the next thing.
Titration as a continuity asset
Weight management with GLP-1 medications involves a ramp-up phase: gradual dose increases over months, with side-effect monitoring at each step. From a pure pharmacological standpoint, this is about tolerance. From a care-design standpoint, it’s something more useful.
For a patient who has never had continuous care before, the titration period is the on-ramp. Every dose step is a scheduled clinical touchpoint. Each touchpoint is a chance to ask about side effects, mood, sleep, eating patterns, energy, what’s working and what isn’t. It’s a structured cadence built into the medication itself: the patient doesn’t have to remember to book, doesn’t have to decide whether something is worth seeing someone about, doesn’t have to navigate appointment systems they’ve actively avoided for years.
This is the kind of continuity these patients have not had. It costs them nothing extra in effort and gives them something they would otherwise have to organise themselves. A regular GP would provide this rhythm for chronic care; for patients without one, the titration phase creates an equivalent.
Two things follow from this. First, the monitoring intervals in the early months should be tighter than the medication strictly requires, not because the safety profile demands it, but because the patient profile benefits from it. Second, the touchpoints should be doing more than checking the medication is tolerated. They should be the moments where the clinician catches what a regular GP would catch in passing: the mood shift, the family history detail that wasn’t on the intake, the new symptom the patient wouldn’t have booked an appointment for on its own.
The bridge back to primary care
Some patients, having experienced this kind of care, will want a regular GP afterwards. Others won’t. Both responses are reasonable.
For the patients who do want one, the program should make it easier. A clinical summary letter written so a GP they’ve never met can pick up the thread. A short list of practices in their area that take new patients. An offered conversation about what to look for in a regular GP. None of this is heavy lifting. Done well, it’s the most useful thing a weight management program can do for a patient’s long-term health beyond the medication itself.
For the patients who don’t want one, the program continues as their primary point of clinical relationship for this episode of care. Closer monitoring intervals. Clearer thresholds for when something needs broader review. An open door to revisit the conversation. And, this is the part that gets skipped, an honest conversation about what the program isn’t. It’s a specialist clinical relationship for weight management. It’s not their cardiologist, their GP, or their mental health team. Where those are needed, it points there and helps them get there.
The principle is the same in both directions: take the patient where they are, and build the connection that makes their care better than what came before.
What this means for GPs
For GPs, the implication is worth being explicit about. Referrals into specialist-governed weight management aren’t only about the patients you already know well. They’re also about patients you’ll never see: the ones who used a telehealth GP once and never came back, and who will only re-engage with primary care if something brings them there.
A well-run program is not a competitor to general practice. It’s one of the few clinical encounters where someone outside primary care has the time and structure to nudge a patient back towards it. The patients who come out of the program with a clinical summary letter and an offered referral are patients you wouldn’t otherwise have met.
We see this as part of the work, not a side benefit of it.
The thing we keep coming back to
The patient without a regular GP is not a problem to be fixed before care begins. They’re a substantial share of who walks through the door, and the structure of good clinical care has real work to do for them. The online intake gathers history the system has rarely asked them to assemble. The titration phase delivers continuity they haven’t previously had. The follow-up structure absorbs the long-term thread a regular GP would otherwise hold. And the bridge back to primary care is offered, not enforced.
It’s not a workaround. For this cohort, it’s the version of care that works.
References used in this piece are listed in the sources section. This article does not constitute medical advice. Speak with your treating clinician about any health decisions.